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Communicating with our patients: the goal of bioethics. 与患者沟通:生命伦理学的目标。
G R Singer, K A Koch

Listening, teaching, understanding, exploring, explaining: these are the foundations of a sound patient-physician relationship. From these skills, we can then proceed to discussions on difficult topics such as preferences for end-of-life care. We can share bad news without destroying hope. We can show what makes the medical profession unlike any other. This issue of The Journal addresses the handling of medical errors, the termination of mechanical ventilatory support, ethical problems in managed care, and confidentiality issues in the computer era. Guidelines for institutional ethics committees also are presented. These are only a sampling of topics that cut to the heart of bioethics, patient communication, and contemporary medical practice. The more that we study such issues, the more we understand the contributions of medical ethics to medical practice, and the better we serve our patients.

倾听、教导、理解、探索、解释:这些是良好医患关系的基础。从这些技巧中,我们可以继续讨论一些困难的话题,比如对临终关怀的偏好。我们可以分享坏消息而不破坏希望。我们可以展示是什么让医疗行业不同于其他行业。本期《华尔街日报》讨论了医疗差错的处理、机械呼吸支持的终止、管理护理中的道德问题以及计算机时代的保密问题。还提出了机构伦理委员会的指导方针。这些只是触及生命伦理、患者沟通和当代医学实践核心的主题的样本。我们对这些问题研究得越多,就越能理解医学伦理对医疗实践的贡献,也就能更好地为患者服务。
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引用次数: 0
A perspective from clinical and business ethics on adverse events in hospitalized patients. 从临床和商业伦理角度看住院患者的不良事件。
J T Wagner, C Meier, T Higdon

Adverse events occur in a significant, but undetermined, number of hospitalized patients. These types of patient injuries are more often the result of faulty systems than human maleficence. A culture exists among health care providers that discourages the reporting of such events and resists the implementation of formal efforts to eliminate them. This resistance serves to perpetuate the problem. Both business and clinical ethics argue that sound reasons exist for hospitals to reduce, if not eliminate, adverse events. To do so is cost effective, particularly in a managed care environment. It is also at the heart of responsible professional behavior. Physicians are afforded an opportunity to be at the forefront in this quality improvement effort.

不良事件发生在大量住院患者中,但数量尚未确定。这些类型的病人伤害往往是系统故障的结果,而不是人为的恶意。在卫生保健提供者中存在着一种文化,这种文化不鼓励报告此类事件,并抵制为消除此类事件而采取的正式努力。这种抵制使问题长期存在。商业伦理和临床伦理都认为,医院有充分的理由减少(如果不能消除)不良事件。这样做具有成本效益,特别是在管理式医疗环境中。这也是负责任的职业行为的核心。医生有机会站在质量改进工作的最前沿。
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引用次数: 0
The new health care triangle: the ethics of managed care. 新的医疗保健三角:管理式医疗的伦理。
K A Koch, E R Griffin
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引用次数: 0
Synopsis of a practical guide: guidelines for ethics committees. 实用指南概要:伦理委员会指南。
B Mulvey
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引用次数: 0
Medicine and money: an approach to compensating university physicians. 医学和金钱:一种补偿大学医生的方法。
B L Maria, H H Tosi

Academic medical centers have been restructuring faculty compensation plans because decreasing clinical revenues have created budgetary problems. We propose an overall compensation strategy designed to reward high performance of university physicians. The approach incorporates Management by Objectives to improve communication of expectations within the organization and provide college of medicine leadership with much needed mechanisms to align faculty compensation with productivity.

学术医疗中心一直在调整教师薪酬计划,因为临床收入的减少造成了预算问题。我们提出了一个整体的薪酬策略,旨在奖励高绩效的大学医生。该方法结合了目标管理,以改善组织内期望的沟通,并为医学院领导层提供了急需的机制,使教师薪酬与生产力保持一致。
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引用次数: 0
Sharks, alligators, barracudas, and other biting animals in Florida waters. 佛罗里达水域的鲨鱼、短吻鳄、梭鱼和其他咬人动物。
G H Burgess, M T Callahan, R J Howard
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引用次数: 0
Drowning and near drowning. 溺水和接近溺水。
A Gabrielli, A J Layon
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引用次数: 0
Venomous marine animals of Florida: morphology, behavior, health hazards. 佛罗里达的有毒海洋动物:形态,行为,健康危害。
S Schwartz, T Meinking

This article reviews the dangers related to marine animal envenomations in Florida. Venomous marine animals exhibit diverse mechanisms of injury and toxicity. Information regarding the morphology, behavior, and health hazards of these dangerous organisms is presented to help medical personnel recognize, diagnose and treat marine envenomations. Hazardous marine animals discussed in this review include both invertebrates and vertebrates. Stinging invertebrate animals include sponges, coelenterates (jellyfish, hydroids, corals, and sea anemones), echinoderms (sea urchins, starfish and sea cucumbers), annelid worms (bristleworm), and mollusks (cone shells, octopi and nudibranches). Stinging vertebrates discussed include stingrays, catfish, scorpionfish, and leatherjacks.

这篇文章回顾了与佛罗里达州海洋动物中毒有关的危险。有毒海洋动物表现出多种伤害和毒性机制。有关这些危险生物的形态、行为和健康危害的信息被提出,以帮助医务人员识别、诊断和治疗海洋中毒。本文讨论的危险海洋动物包括无脊椎动物和脊椎动物。有刺的无脊椎动物包括海绵动物、腔肠动物(水母、水螅、珊瑚和海葵)、棘皮动物(海胆、海星和海参)、环节蠕虫(鬃虫)和软体动物(锥壳、章鱼和裸鳃动物)。讨论的有刺脊椎动物包括黄貂鱼、鲶鱼、蝎子鱼和刺皮鱼。
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引用次数: 0
Cruise ship medical facilities: caveat emptor. 游轮医疗设施:概不负责。
B S Feuer
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引用次数: 0
Scuba diving accidents: decompression sickness, air embolism. 水肺潜水事故:减压病,空气栓塞。
T J Gallagher
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引用次数: 0
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The Journal of the Florida Medical Association
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